Journal of Assisted Reproduction and Genetics

, Volume 35, Issue 7, pp 1289–1294 | Cite as

Non-O blood group and outcomes of in vitro fertilization

  • M. Di NisioEmail author
  • A. Ponzano
  • G. M. Tiboni
  • M. D. Guglielmi
  • A. W. S. Rutjes
  • E. Porreca
Assisted Reproduction Technologies



Retrospective and cross-sectional studies suggested that non-O blood group may be associated with failures of in vitro fertilization (IVF), but data remain controversial. The aim of this observational cohort study was to prospectively evaluate the effect of non-O blood type on clinical outcomes of IVF.


Women < 40 years who underwent IVF and had ABO blood type recorded as part of the routine workup were eligible. The primary study outcome was live birth. Secondary outcomes included spontaneous abortion, positive pregnancy test, and clinical pregnancy.


A total of 497 women with a mean age of 34.6 (standard deviation 3.2) years were included. The mean number of embryos transferred was 2.3 (standard deviation 0.6). The most common ABO blood types were O (n = 213, 42.9%) and A (n = 203, 40.8%), while 63 (12.7%) and 18 (3.6%) women had the B and AB blood types, respectively. Differences in live birth (21.8 vs. 24.3%, odds ratio [OR] 1.17; 95% confidence intervals [CI], 0.76 to 1.78), positive pregnancy test (37.9 vs. 36.6%, OR 0.96; 95% CI, 0.66 to 1.38), clinical pregnancy (35.1 vs. 33.8%, OR 0.95; 95% CI, 0.66 to 1.39), and spontaneous abortion (12.3 vs. 9.2%, OR 0.72; 95% CI, 0.41 to 1.29) between women with O and non-O blood type were not statistically significant.


In a prospective cohort study, we confirmed the lack of a significant association between non-O blood type and clinical outcomes of IVF. Further studies are needed to clarify whether non-O blood group has any prognostic relevance in women undergoing IVF.


ABO blood type Thrombophilia Assisted reproductive techniques 


Authors’ contribution

Conception and design (MDN, EP); acquisition of data (MDN, AP, GMT, MDG); analysis and interpretation of data (MDN, AWSR, AP, GMT, MDG, EP); drafting the article or revising it critically for important intellectual content (MDN, AWSR, AP, GMT, MDG, EP); final approval of the version to be published (MDN, AWSR, AP, GMT, MDG, EP).

Compliance with ethical standards

Conflict of interest

MDN has received personal fees from Daiichi-Sankyo and Bayer outside the submitted work. All other authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    MacCallum P, Bowles L, Keeling D. Diagnosis and management of heritable thrombophilias. BMJ. 2014;349:g4387.CrossRefPubMedGoogle Scholar
  2. 2.
    Seligsohn U, Lubetsky A. Genetic susceptibility to venous thrombosis. N Engl J Med. 2001;344:1222–31.CrossRefPubMedGoogle Scholar
  3. 3.
    Hossain N, Paidas MJ. Adverse pregnancy outcome, the uteroplacental interface, and preventative strategies. Semin Perinatol. 2007;31:208–12.CrossRefPubMedGoogle Scholar
  4. 4.
    Di Nisio M, Rutjes AW, Ferrante N, Tiboni GM, Cuccurullo F, Porreca E. Thrombophilia and outcomes of assisted reproduction technologies: a systematic review and meta-analysis. Blood. 2011;118:2670–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Jick H, Slone D, Westerholm B, Inman WH, Vessey MP, Shapiro S, et al. Venous thromboembolic disease and ABO blood type. A cooperative study. Lancet. 1969;1:539–42.CrossRefPubMedGoogle Scholar
  6. 6.
    Medalie JH, Levene C, Papier C, Goldbourt U, Dreyfuss F, Oron D, et al. Blood groups, myocardial infarction and angina pectoris among 10,000 adult males. N Engl J Med. 1971;285:1348–53.CrossRefPubMedGoogle Scholar
  7. 7.
    Talbot S, Wakley EJ, Langman MJ. A19 A29 B, and O blood groups, Lewis blood-groups, and serum triglyceride and cholesterol concentrations in patients with venous thromboembolic disease. Lancet. 1972;1:1152–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Ohira T, Cushman M, Tsai MY, Zhang Y, Heckbert SR, Zakai NA, et al. ABO blood group, other risk factors and incidence of venous thromboembolism: the longitudinal investigation of thromboembolism etiology (LITE). J Thromb Haemost. 2007;5:1455–61.CrossRefPubMedGoogle Scholar
  9. 9.
    Wu O, Bayoumi N, Vickers MA, Clark P. ABO(H) blood groups and vascular disease: a systematic review and meta-analysis. J Thromb Haemost. 2008;6:62–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Gándara E, Kovacs MJ, Kahn SR, Wells PS, Anderson DA, Chagnon I, et al. Non-OO blood type influences the risk of recurrent venous thromboembolism. A cohort study. Thromb Haemost. 2013;110:1172–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Sode BF, Allin KH, Dahl M, Gyntelberg F, Nordestgaard BG. Risk of venous thromboembolism and myocardial infarction associated with factor V Leiden and prothrombin mutations and blood type. CMAJ. 2013;185:E229–37.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Dentali F, Sironi AP, Ageno W, Turato S, Bonfanti C, Frattini F, et al. Non-O blood type is the commonest genetic risk factor for VTE: results from a metaanalysis of the literature. Semin Thromb Hemost. 2012;38:535–48.CrossRefPubMedGoogle Scholar
  13. 13.
    O’Donnell J, Boulton FE, Manning RA, Laffan MA. Amount of H antigen expressed on circulating von Willebrand factor is modified by ABO blood group genotype and is a major determinant of plasma von Willebrand factor antigen levels. Arterioscler Thromb Vasc Biol. 2002;22:335–41.CrossRefPubMedGoogle Scholar
  14. 14.
    Schleef M, Strobel E, Dick A, Frank J, Schramm W, Spannagl M. Relationship between ABO and secretor genotype with plasma levels of factor VIII and von Willebrand factor in thrombosis patients and control individuals. Br J Haematol. 2005;128:100–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Orstavik KH, Magnus P, Reisner H, Berg K, Graham JB, Nance W, et al. Factor IX in a twin population. Evidence for a major effect of ABO locus on factor VIII level. Am J Hum Genet. 1985;37:89–101.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Xiao J, Feng Y, Li X, Li W, Fan L, Liu J, et al. Expression of ADAMTS13 in normal and abnormal placentae and its potential role in angiogenesis and placenta development. Arterioscler Thromb Vasc Biol. 2017;37:1748–56.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Schwimmer WB, Ustay KA, Behrman SJ. An evaluation of immunologic factors of infertility. Fertil Steril. 1967;18:167–80.CrossRefPubMedGoogle Scholar
  18. 18.
    Tyler A, Tyler ET, Denny PC. Concepts and experiments in immunoreproduction. Fertil Steril. 1967;18:153–66.CrossRefPubMedGoogle Scholar
  19. 19.
    Nejat EJ, Jindal S, Berger D, Buyuk E, Lalioti M, Pal L. Implications of blood type for ovarian reserve. Hum Reprod. 2011;26:2513–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Timberlake KS, Foley KL, Hurst BS, Matthews ML, Usadi RS, Marshburn PB. Association of blood type and patient characteristics with ovarian reserve. Fertil Steril. 2013;100:1735–9.CrossRefPubMedGoogle Scholar
  21. 21.
    De Mouzon J, Hazout A, Cohen-Bacrie M, Belloc S, Cohen-Bacrie P. Blood type and ovarian reserve. Hum Reprod. 2012;27(5):1544–5.CrossRefPubMedGoogle Scholar
  22. 22.
    Sengul O, Dilbaz B, Yerebasmaz N, Dede S, Altinbas S, Erkaya S. Only female age, and not blood type, is associated with ovarian reserve. Int J Fertil Steril. 2014;8:143–6.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Goldsammler M, Jindal SK, Kallen A, Mmbaga N, Pal L. Blood type predicts live birth in the infertile population. J Assist Reprod Genet. 2015;32:551–5.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Pereira N, Patel HH, Stone LD, Christos PJ, Elias RT, Spandorfer SD, et al. Association between ABO blood type and live-birth outcomes in single embryo transfer cycles. Fertil Steril. 2017;S0015-0282(17):31741–7.Google Scholar
  25. 25.
    Di Nisio M, Porreca E, Di Donato V, Tiboni GM. Plasma concentrations of D-dimer and outcome of in vitro fertilization. J Ovarian Res. 2014;7:58.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Behrman SJ, Buettner-Janusch J, Heglar R, Gershowitz H, Tew WL. ABO (H) blood incompatibility as a cause of infertility: a new concept. Am J Obstet Gynecol. 1960;79:847–55.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Vascular Medicine, Academic Medical CenterAmsterdamThe Netherlands
  2. 2.Department of Medicine and Ageing SciencesUniversity G. D’AnnunzioChieti-PescaraItaly
  3. 3.Unit of Assisted Reproductive Technology, Ortona General HospitalOrtona (Chieti)Italy
  4. 4.Department of Internal Medicine, Ospedale SS. ma AnnunziataChietiItaly
  5. 5.Institute of Social and Preventive MedicineUniversity of BernBernSwitzerland
  6. 6.Institute of Primary Health CareUniversity of BernBernSwitzerland
  7. 7.Department of Medical, Oral and Biotechnological SciencesUniversity G. D’AnnunzioChietiItaly

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